Pathology Handbook

Preferred Specimen Type

Plasma

Blood

Optional Specimen Type

Serum

Collection & Request Instructions

Dietary restriction or special diet.

Collection & Request Instructions

Role in the diagnosis of Carcinoid Syndrome

Clinical Staff should ensure that patients have an appropriate diet during the urine collection; no phenothiazines or serotonin-containing foods should be consumed.( eg bananas, pineapples, red plums, walnuts, avocadoes, eggplant or tomatoes).

Role in the diagnosis of Carcinoid Syndrome

Special Requirements : Patient should avoid ingestion of bananas 24 hrs prior commencement of urine collection and during the period of urine collection

External Laboratory

St Vincent's Pathology

Women's and Children's Pathology Services, RCH

Notes

Reference Interval:

5HIAA: < 50 umol/24hrs

Assay Performed: Complex Biochemistry, RCH
Phone:  9345 4200
Laboratory Hours: 0830 - 1700 Monday to Friday, (excluding Pub Hol)
 

Collection & Request Instructions

This form must accompany the standard pathology request form/referral letter and specimen for all ADAMTS-13 requests.

https://pathology.alfred.org.au/handbook/downloads/ADAMTS-13%20request%20form.docx

This form must accompany the standard pathology request form/referral letter and specimen for all ADAMTS-13 requests.

https://monashpathology.org/wp-content/uploads/2024/09/FOR-HE-147.pdf

Collection & Request Instructions

Aldosterone excretion is, physologically, inversely influenced by sodium status and must be interpretated in relation to sodium excretion.

Test no longer available for ordering.

Preferred Specimen Type

Serum

Blood

Optional Specimen Type

Plasma

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

Lithium Heparin (with Gel)

SST

Frequency

Daily

External Transport Instructions

Must be approved by Chemical Pathologist.

Must be approved by Chemical Pathologist.

Alpha sub-unit Reference Interval (serum/plasma):

Male:  0.00 – 0.70 IU/L

Female - Premenopausal:   0.00 – 0.60 IU/L

Female - Postmenopausal:  0.00 – 1.30 IU/L

Pregnancy is associated with marked elevations in free alpha subunit concentration related to increases in hCG secretion.  Free alpha subunit results are of limited use during pregnancy.

SydPath Endocrinology lab: 02 8382 9100.

Test performed weekly (usually Friday)

Transport Instructions between sites and/or laboratories

Room Temperature

Send to lab immediately
On Ice

Processing Instructions

Centrifuge
Store at 4'C

Centrifuge
Aliquot
Freeze Immediately

External Transport Instructions

Send at 4'C with Ice Pack

Send Frozen on Dry Ice

Alternative names

Ganglioside ab., GM1 ab.

Transport Instructions between sites and/or laboratories

Transport to pathology Queensland frozen (-20deg) 

Processing Instructions

Centrifuge immediately
Aliquot
Freeze Immediately
Store frozen

Centrifuge immediately
Aliquot
Freeze Immediately
Store at -20'C

External Transport Instructions

A copy of a recent Fibrinogen result must accompany the sample. 

Preferred Specimen Type

Serum

Blood

Optional Specimen Type

Plasma

Preferred Specimen Type

Serum

Blood

Optional Specimen Type

Plasma

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

Lithium Heparin (with Gel)

SST

Notes

Therapeutic Range:  4.0 - 12.0 mg/L

Critical results notification:  20 mg/L

Please note: from 01/10/2024 units have changed from umol/L to mg/L.

To convert: mg/L x 4.23 = umol/L

Therapeutic Range:  4.0 - 12.0 mg/L

Critical results notification:  20.0 mg/L

Please note: from 01/10/2024 units have changed from umol/L to mg/L.

To convert: mg/L x 4.23 = umol/L

Preferred Specimen Type

Serum

Blood

Optional Specimen Type

Plasma

Notes

Therapeutic Range:  17—51 umol/L

Therapeutic Range:  4.0 - 12.0 mg/L

Critical results notification:  20 mg/L

Please note: from 01/10/2024 units have changed from umol/L to mg/L.

To convert: mg/L x 4.23 = umol/L

Processing Instructions

Aliquot
Store at 4'C

Aliquot
Store at -20'C

Collection & Request Instructions

Patient should avoid ingestion of bananas 24 hrs prior to commencement of urine collection.

Patient should avoid ingestion of bananas 24 hrs prior to commencement of urine collection.

Must be approved by Chemical Pathologist.

Notes

Measurement of urine catecholamines are no longer offered for adult patients. The preferred tests for the diagnosis and monitoring of phaeochromocytoma and paragangliomas are plasma and urine metanephrines.

For paediatric patients, requests for urine catecholamines will be referred to the laboratory at RCH where catecholamines including HVA are measured.

Measurement of urine catecholamines are no longer offered for adult patients. The preferred tests for the diagnosis and monitoring of phaeochromocytoma and paragangliomas are plasma and urine metanephrines.

For paediatric patients, requests for urine catecholamines will be referred to the laboratory at RCH where catecholamines including HVA are measured.

Assay Performed:  Complex Biochemistry, RCH. Ph: 9345 4200

Laboratory Hours: 0830 - 1700 Monday to Friday, (excluding Pub Hol)

Assay Frequency: Weekly

Collection & Request Instructions

Drugs to avoid before or during urine collection—
Aldomet, methenamine, methenamine hippurate, levodopa, caffeine, aminophylline, theophylline, ethanol,guanethidine and reserpine.

One day PRIOR to collecting the 24hr urine the patient should abstain from bananas, coffee, pineapple and walnuts.

Patient should avoid ingestion of bananas 24 hrs prior to commencement of urine collection.

External Transport Instructions

Send at 4'C with Ice Pack

Send at ambient temperature

External Laboratory

Women's and Children's Pathology Services, RCH

External Transport Instructions

Send at 4'C with Ice Pack

Notes

Reference Ranges (Adults):
  Adrenaline:            < 110  nmol/day
  Noradrenaline:      < 475  nmol/day
  Dopamine:             < 2600  nmol/day

Reference Ranges (Children):

Consult Drug laboratory Ext. 63049.

Measurement of urine catecholamines are no longer offered for adult patients. The preferred tests for the diagnosis and monitoring of phaeochromocytoma and paragangliomas are plasma and urine metanephrines.

For paediatric patients, requests for urine catecholamines will be referred to the laboratory at RCH where catecholamines including HVA are measured.

Collection & Request Instructions

Drugs to avoid before or during urine collection—
Aldomet, methenamine, methenamine hippurate, levodopa, caffeine, aminophylline, theophylline, ethanol,guanethidine and reserpine.

One day PRIOR to collecting the  urine the patient should abstain from bananas, coffee, pineapple and walnuts.

One day PRIOR to collecting the  urine the patient should abstain from bananas, 

External Laboratory

Women's and Children's Pathology Services, RCH

Notes

Note:  24hr urine collection in an acid bottle is preferred specimen

Random(spot) Urine Catecholamines - used for External referrals, usually only children 

Reference Intervals (Children):

Consult Drug laboratory Ext. 63049.

Random(spot) Urine Catecholamines will only be accepted for children where 24hr collection is not possible.

Notes

Method: LC-MS/MS

Therapeutic range : 2.0 - 20.0 mg/L

Method: LC-MS/MS

Target range : 2.0 - 20.0 mg/L

Collection & Request Instructions

** Research use only **

Frequency

Weekdays

Notes

Method: LC-MS/MS

Therapeutic range : 2.0 - 20.0 mg/L

Volume (Adults)

10 mL

5 mL

Minimum/Paediatric Volume

1-2 mL

Transport Instructions between sites and/or laboratories

Room Temperature

Room Temperature
See Detailed Information

Transport Instructions between sites and/or laboratories

Deliver within 3 days

RT or 4C, deliver within 7 days

External Laboratory

PathWest Royal Perth Hospital

PathWest QEII Medical Centre

Frequency

Monthly

Registration Instructions

This is NOT Chromosome Analysis - Microarray

For oncology related Chromosomal/Karyotyping tests, please see the following listing:

Cytogenetics - St V's

This is NOT Chromosome Analysis - Microarray

For oncology related Chromosomal/Karyotyping tests, please see the following listing: Cytogenetics - St V's

Alternative names

Karyotype, Karyotyping

Constitutional Karyotyping, Germline Karyotyping

External Laboratory

Victorian Clinical Genetics Services, RC Hospital

Monash Pathology

External Transport Instructions

This request must be approved by a haematology registrar / pathologist prior to sending

Notes

Please see link below for external laboratory requirements

http://www.vcgs.org.au/pathology/sections/Cytogenetics/?docid=8bf38b05-46ca-4ebf-b3cf-992e00eff2b0

IMPORTANT

Samples for constitutional karyotyping should be sent to Monash Pathology the same day as collection or at the latest the next morning.

Transport Instructions between sites and/or laboratories

On Ice

Notes

Needs approval by Immunology-Haem

External Laboratory

SEALS - Sutherland Hospital

SEALS - Prince Of Wales

External Transport Instructions

Approval via immunology required

Preferred Specimen Type

Serum

Blood

Optional Specimen Type

Plasma

Notes

Therapeutic Range:  0.6—1.0 nmol/L

Toxic Range:  > 2.9 nmol/L

Therapeutic Range:  0.5 - 1.0 ug/L

Critical results notification:  > 2.0 ug/L

Please note: from 01/10/2024 units have changed from nmol/L to ug/L.

To convert: ug/L x 1.281 = nmol/L

External Laboratory

SA Pathology - FMC (Flinders Medical Centre)

Victorian Clinical Genetics Services, RC Hospital

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

Lithium Heparin (with Gel)

SST

Frequency

Weekly
By Arrangement

Frequency

Weekly
By Arrangement

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

Lithium Heparin (with Gel)

SST

Preferred Specimen Type

Plasma

Blood

Alternative names

Fibrinogen - Clauss, Clauss - Fibrinogen

Notes

Reference Range: 2.0—4.0 g/L

Reference Range: 2.0—4.0 g/L

Processing Instructions

** Research use only **

Frequency

Weekdays

Notes

Method:LC-MS/MS

Target range: 20.0 - 80.0 mg/L

Assay name

Freideich Ataxia

Friedreich ataxia

Alternative names

MS FAGENE

MS FAGENE, Friedreich's ataxia FXN

Volume (Adults)

3 mL

Minimum/Paediatric Volume

5 mL

1 mL

Preferred Container Type

EDTA 10 mL

EDTA 6 mL

Processing Instructions

Store at 4'C

Do Not Centrifuge

External Laboratory

Victorian Clinical Genetics Services, RC Hospital

NSW Health Pathology, (SSWPS) - Concord Hospital

External Transport Instructions

This requst must be approved by the haematology registrar prior to sending

Notes

Please see link below for external laboratory requirements and costs

http://www.vcgs.org.au/pathology/sections/MolecularGenetics/?docid=1b043caa-429f-4faf-8c0c-423414a5e8d2

NSW Health Pathology Details

Preferred Specimen Type

Serum

Blood

Optional Specimen Type

Plasma

Notes

Reference Intervals:
  Female
    Follicular:        3.4—21.6 U/L
    MidCycle:        5.0—20.8 U/L
    Luteal:             1.1—14.0 U/L
    Menopausal:  20— >100 U/L

  Male:                  1.4—13.6 U/L

Reference Intervals:
  Female
    Follicular:        3.4—21.6 U/L
    MidCycle:        5.0—20.8 U/L
    Luteal:             1.1—14.0 U/L
    Post-Menopausal:  20— >100 U/L

  Male:                  1.4—13.6 U/L

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

SST

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

Lithium Heparin (with Gel)

SST

Preferred Specimen Type

Serum

Blood

Optional Specimen Type

Plasma

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

Lithium Heparin (with Gel)

SST

Preferred Specimen Type

Serum

Blood

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

SST

Assay name

Huntington

Huntington Disease

Alternative names

Huntington Disease repeat number

Volume (Adults)

4 mL

Minimum/Paediatric Volume

5 mL

0.5 mL

Preferred Container Type

EDTA 10 mL

EDTA 4 mL

Transport Instructions between sites and/or laboratories

Transport at room temperature

Processing Instructions

Do NOT spin. Keep at room temperature

External Transport Instructions

Send at 4'C with Ice Pack

Send at ambient temperature

External Transport Instructions

This request must be approved by the haematology registrar prior to sending

External Laboratory

Victorian Clinical Genetics Services, RC Hospital

NSW Health Pathology - Concord Molecular Med Lab

External Transport Instructions

This requst must be approved by the haematology registrar prior to sending

This request must be approved by the haematology registrar prior to sending

Notes

Please see link below for external laboratory requirements and costs

http://www.vcgs.org.au/pathology/sections/MolecularGenetics/?docid=5a502d68-e019-43ee-9d05-9ee53c530da0

NSW Health Pathology Test Details

Preferred Specimen Type

Serum

Blood

Optional Specimen Type

Plasma

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

Lithium Heparin (with Gel)

SST

Transport Instructions between sites and/or laboratories

___

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

Lithium Heparin (with Gel)

SST

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

Lithium Heparin (with Gel)

SST

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

Lithium Heparin (with Gel)

SST

Notes

Notes

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

Lithium Heparin (with Gel)

SST

Optional Container Type

SST

Preferred Specimen Type

Serum

Blood

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

SST

Alternative names

MT-ND1 m.3460G>A, MT-ND4 m.11778G>A, MT-ND6 m.14484T>C, Leber Hereditary Optic Neuropathy

Volume (Adults)

4 mL

Minimum/Paediatric Volume

3 mL

Preferred Container Type

EDTA 10 mL

EDTA 10 mL
EDTA 4 mL

Collection & Request Instructions

If use 4mL EDTA tubes, use 2 tubes ie 2X 4mL EDTA

Transport Instructions between sites and/or laboratories

At room temperature or 4C

Optional Container Type

SST

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

Lithium Heparin (with Gel)

SST

Optional Container Type

SST

Registration Instructions

Includes LFT + AST

Includes LFT + AST

Preferred Specimen Type

Serum
Plasma

Blood

Optional Container Type

SST

Collection & Request Instructions

**For research use only**

Frequency

Weekdays

Collection & Request Instructions

Muscle Biopsy

Muscle biopsy for neurodegenerative and metabolic studies are processed by the Victorian Neuromuscular Laboratory Service (VNLS) which is located within the Anatomical Pathology Department of Alfred Pathology Service at Alfred Health.

Clinicians Please Note: VNLS must receive samples before 4.00pm Monday to Friday to enable optimal handling and processing to occur. Please ensure you allow sufficient transport time when scheduling the time of biopsy.

Requests and Reports

A request form must accompany the specimen. The request form must contain full details (full name, address, contact number) of the requesting doctor and who should receive a copy of the report, including the name of the treating neurologist.

VNLS is a statewide referral service with a broad clinician referral base. Please provide clear and precise details so reports can be directed to the appropriate people.

Specimen Collection

Correct handling of a muscle biopsy is important for accurate interpretation of the specimen.

One (1) fresh specimen of muscle is required.

1) A single 20 x 10 x 10 mm rectangular piece of muscle is collected from the patient and placed in a dry sterile container (yellow lid).

2) Place this specimen in an Esky with ice cubes and dispatch to the VNLS immediately.

3) Please deliver the specimen before 4pm.

Please:

• DO NOT Freeze the specimen.

• DO NOT Immerse the specimen in any fluid.

• DO NOT use any Diathermy instrument on the muscle specimen.

• DO NOT Infuse the muscle with local anaesthetic.

Specimen Dispatch

Deliver the muscle biopsies and completed paperwork to:

Victorian Neuromuscular Laboratory Service

Alfred Pathology Service
Ground Floor 
Main Ward Block                                                                                                      Commercial Rd
Melbourne
Victoria 3004

Victorian Neuromuscular Laboratory Service– General Information

Muscle Biopsy

Muscle biopsy for neurodegenerative and metabolic studies are processed by the Victorian Neuromuscular Laboratory Service (VNLS) which is located within the Anatomical Pathology Department of Alfred Pathology Service at Alfred Health.

Clinicians Please Note: VNLS must receive samples before 4.00pm Monday to Friday to enable optimal handling and processing to occur. Please ensure you allow sufficient transport time when scheduling the time of biopsy.

Requests and Reports

A request form must accompany the specimen. The request form must contain full details (full name, address, contact number) of the requesting doctor and who should receive a copy of the report, including the name of the treating neurologist.

VNLS is a statewide referral service with a broad clinician referral base. Please provide clear and precise details so reports can be directed to the appropriate people.

Specimen Collection

Correct handling of a muscle biopsy is important for accurate interpretation of the specimen.

One (1) fresh specimen of muscle is required.

1) A single 20 x 10 x 10 mm rectangular piece of muscle is collected from the patient and placed in a dry sterile container (yellow lid).

2) Place this specimen in an Esky with ice cubes and dispatch to the VNLS immediately.

3) Please deliver the specimen before 4pm.

Please:

• DO NOT Freeze the specimen.

• DO NOT Immerse the specimen in any fluid.

• DO NOT use any Diathermy instrument on the muscle specimen.

• DO NOT Infuse the muscle with local anaesthetic.

Specimen Dispatch

Deliver the muscle biopsies and completed paperwork to:

Victorian Neuromuscular Laboratory Service

Alfred Pathology Service Central Specimen Processing
Ground Floor, Main Ward Block
The Alfred
55 Commercial Rd
Melbourne, VIC 3004

Victorian Neuromuscular Laboratory Service– General Information

Collection & Request Instructions

Muscle Biopsy

Muscle biopsy for neurodegenerative and metabolic studies are processed by the Victorian Neuromuscular Laboratory Service (VNLS) which is located within the Anatomical Pathology Department of Alfred Pathology Service at Alfred Health.

Clinicians Please Note: VNLS must receive samples before 4.00pm Monday to Friday to enable optimal handling and processing to occur. Please ensure you allow sufficient transport time when scheduling the time of biopsy.

Requests and Reports

A request form must accompany the specimen. The request form must contain full details (full name, address, contact number) of the requesting doctor and who should receive a copy of the report, including the name of the treating neurologist.

VNLS is a statewide referral service with a broad clinician referral base. Please provide clear and precise details so reports can be directed to the appropriate people.

Specimen Collection

Correct handling of a muscle biopsy is important for accurate interpretation of the specimen.

• Please deliver the specimen before 4pm.

• Please do not freeze the specimen.

• Do not immerse the specimen in any fluid.

• Do not use any diathermy instrument on the muscle specimen.

• Do not infuse the muscle with local anaesthetic.

One (1) fresh specimen of muscle is required.

A single 20 x 10 x 10 mm rectangular piece of muscle is collected from the patient and placed in a dry sterile container (yellow lid).

Place this specimen in an Esky with ice cubes and dispatch to the VNLS immediately.

Muscle Biopsy Kits Are No Longer Provided

Note: As of 2017 VNLS no longer provides muscle biopsy kits for specimen sampling and packaging. Detailed instructions on collection procedure can be downloaded from the link below or via the VNLS website.

Specimen Dispatch

Return the muscle biopsies and completed paperwork to:

Victorian Neuromuscular Laboratory Service

Alfred Pathology Central Specimen Processing
The Alfred
55 Commercial Rd
Melbourne
Victoria 3004

Important Note: VNLS is unable to provide a collection service for the return of specimens. It is the responsibility of each hospital or clinic to arrange return delivery of the specimen to Alfred Pathology Service.

Victorian Neuromuscular Laboratory Service– General Information

Muscle Biopsy

Muscle biopsy for neurodegenerative and metabolic studies are processed by the Victorian Neuromuscular Laboratory Service (VNLS) which is located within the Anatomical Pathology Department of Alfred Pathology Service at Alfred Health.

Clinicians Please Note: VNLS must receive samples before 4.00pm Monday to Friday to enable optimal handling and processing to occur. Please ensure you allow sufficient transport time when scheduling the time of biopsy.

Requests and Reports

A request form must accompany the specimen. The request form must contain full details (full name, address, contact number) of the requesting doctor and who should receive a copy of the report, including the name of the treating neurologist.

VNLS is a statewide referral service with a broad clinician referral base. Please provide clear and precise details so reports can be directed to the appropriate people.

Specimen Collection

Correct handling of a muscle biopsy is important for accurate interpretation of the specimen.

One (1) fresh specimen of muscle is required.

1) A single 20 x 10 x 10 mm rectangular piece of muscle is collected from the patient and placed in a dry sterile container (yellow lid).

2) Place this specimen in an Esky with ice cubes and dispatch to the VNLS immediately.

3) Please deliver the specimen before 4pm.

Please:

• DO NOT Freeze the specimen.

• DO NOT Immerse the specimen in any fluid.

• DO NOT use any Diathermy instrument on the muscle specimen.

• DO NOT Infuse the muscle with local anaesthetic.

Specimen Dispatch

Deliver the muscle biopsies and completed paperwork to:

Victorian Neuromuscular Laboratory Service

Alfred Pathology Service
Ground Floor 
Main Ward Block                                                                                                      Commercial Rd
Melbourne
Victoria 3004

Victorian Neuromuscular Laboratory Service– General Information

Collection & Request Instructions

Muscle Biopsy

Muscle biopsy for neurodegenerative and metabolic studies are processed by the Victorian Neuromuscular Laboratory Service (VNLS) which is located within the Anatomical Pathology Department of Alfred Pathology Service at Alfred Health.

Clinicians Please Note: VNLS must receive samples before 4.00pm Monday to Friday to enable optimal handling and processing to occur. Please ensure you allow sufficient transport time when scheduling the time of biopsy.

Requests and Reports

A request form must accompany the specimen. The request form must contain full details (full name, address, contact number) of the requesting doctor and who should receive a copy of the report, including the name of the treating neurologist.

VNLS is a statewide referral service with a broad clinician referral base. Please provide clear and precise details so reports can be directed to the appropriate people.

Specimen Collection

Correct handling of a muscle biopsy is important for interpretation of the specimen.

• Please deliver the specimen before 4pm.

• Please do not freeze the specimen.

• Do not immerse the specimen in any fluid.

• Do not use any diathermy instrument on the muscle specimen.

• Do not infuse the muscle with local anaesthetic.

One (1) fresh specimen of muscle is required.

A single 20 x 10 x 10 mm rectangular piece of muscle is collected from the patient and placed in a dry sterile container (yellow lid).

Place this specimen in an Esky with ice cubes and dispatch to the VNLS immediately.

Muscle Biopsy Kits Are No Longer Provided

Note: As of 2017 VNLS no longer provides muscle biopsy kits for specimen sampling and packaging. Detailed instructions on collection procedure can be downloaded from the link below or via the VNLS website.

Specimen Dispatch

Return the muscle biopsies and completed paperwork to:

Victorian Neuromuscular Laboratory Service

Alfred Pathology Central Specimen Processing
The Alfred
55 Commercial Rd
Melbourne
Victoria 3004

Important Note: VNLS is unable to provide a collection service for the return of specimens. It is the responsibility of each hospital or clinic to arrange return delivery of the specimen to Alfred Pathology Service.

Victorian Neuromuscular Laboratory Service– General Information

Muscle Biopsy

Muscle biopsy for neurodegenerative and metabolic studies are processed by the Victorian Neuromuscular Laboratory Service (VNLS) which is located within the Anatomical Pathology Department of Alfred Pathology Service at Alfred Health.

Clinicians Please Note: VNLS must receive samples before 4.00pm Monday to Friday to enable optimal handling and processing to occur. Please ensure you allow sufficient transport time when scheduling the time of biopsy.

Requests and Reports

A request form must accompany the specimen. The request form must contain full details (full name, address, contact number) of the requesting doctor and who should receive a copy of the report, including the name of the treating neurologist.

VNLS is a statewide referral service with a broad clinician referral base. Please provide clear and precise details so reports can be directed to the appropriate people.

Specimen Collection

Correct handling of a muscle biopsy is important for accurate interpretation of the specimen.

• Please deliver the specimen before 4pm.

• Please do not freeze the specimen.

• Do not immerse the specimen in any fluid.

• Do not use any diathermy instrument on the muscle specimen.

• Do not infuse the muscle with local anaesthetic.

One (1) fresh specimen of muscle is required.

A single 20 x 10 x 10 mm rectangular piece of muscle is collected from the patient and placed in a dry sterile container (yellow lid).

Place this specimen in an Esky with ice cubes and dispatch to the VNLS immediately.

Muscle Biopsy Kits Are No Longer Provided

Note: As of 2017 VNLS no longer provides muscle biopsy kits for specimen sampling and packaging. Detailed instructions on collection procedure can be downloaded from the link below or via the VNLS website.

Specimen Dispatch

Return the muscle biopsies and completed paperwork to:

Victorian Neuromuscular Laboratory Service

Alfred Pathology Central Specimen Processing
The Alfred
55 Commercial Rd
Melbourne
Victoria 3004

Important Note: VNLS is unable to provide a collection service for the return of specimens. It is the responsibility of each hospital or clinic to arrange return delivery of the specimen to Alfred Pathology Service.

Victorian Neuromuscular Laboratory Service– General Information

Volume (Adults)

4 mL

Minimum/Paediatric Volume

5 mL

4 mL

Preferred Container Type

EDTA 10 mL

EDTA 6 mL

Processing Instructions

Do Not Centrifuge
Store at 4'C

Do Not Centrifuge

External Laboratory

Victorian Clinical Genetics Services, RC Hospital

PathWest - QE II Hospital

External Transport Instructions

Send at 4'C with Ice Pack

Send at ambient temperature

External Transport Instructions

This requst must be approved by the haematology registrar prior to sending

Notes

Please see link below for external laboratory requirements and costs

http://www.vcgs.org.au/pathology/sections/MolecularGenetics/?docid=52e429a4-7853-4b68-8efd-4d9924eff107

PathWest Pathology Details

Registration Instructions

This test requires approval by the Chemical Pathologist.

Collection & Request Instructions

Nerve Biopsy

Nerve biopsy for neurodegenerative studies are processed by the Victorian Neuromuscular Laboratory Service (VNLS) which is located within the Anatomical Pathology Department of Alfred Pathology Service at Alfred Health.

Clinicians Please Note: VNLS must receive samples before 4.00pm Monday to Friday to enable optimal handling and processing to occur. Please ensure you allow sufficient transport time when scheduling the time of biopsy.

Requests and Reports

A request form must accompany the specimen. The request form must contain full details (full name, address, contact number) of the requesting doctor and who should receive a copy of the report, including the name of the treating neurologist.

VNLS is a statewide referral service with a broad clinician referral base. Please provide clear and precise details so reports can be directed to the appropriate people.

Specimen Collection

Nerve biopsy kit

VNLS provides nerve biopsy kits for appropriate specimen collection and packaging. It is essential to use these kits for sample collection as they contain the appropriate fixative, specimen containers and a nerve hook (1g weight). Each kit contains detailed instructions on nerve collection procedures.

Kits are provided free of charge. Contact the laboratory 48 hours prior to the procedure to ensure a kit can be delivered in time. Kits are delivered via courier at no charge.

Correct handling of nerve biopsies is important for accurate interpretation of the specimen.

• ***Kits supplied with separate 25% glutaraldehyde & cacodylate buffer must be MIXED before use.
• Take 25mm of nerve & tie a suture on the distal end of the nerve.
• Attach nerve hook to the other end.
• Place the nerve with suture & hook into the glass tube provided (2.5% glut fixative).
• Clamp the suture in the stopper of the glass tube & make sure the hook is suspended (refer to picture).
• Please keep the glass tube UPRIGHT & place the glass tube into the plastic cup provided.
• Place the cup into an esky surrounded by ice cubes & dispatch to VNLS.

Specimen Dispatch

Return the nerve biopsy and completed paperwork to:

Victorian Neuromuscular Laboratory Service

Alfred Pathology Central Specimen Processing
The Alfred
55 Commercial Rd
Melbourne
Victoria 3004

VNLS must receive samples before 4.00pm Monday to Friday so ensure you allow sufficient transport time when scheduling a biopsy.

Victorian Neuromuscular Laboratory Service– General Information

Nerve Biopsy

Nerve biopsy for neurodegenerative studies are processed by the Victorian Neuromuscular Laboratory Service (VNLS) which is located within the Anatomical Pathology Department of Alfred Pathology Service at Alfred Health.

Clinicians Please Note: VNLS must receive samples before 4.00pm Monday to Friday to enable optimal handling and processing to occur. Please ensure you allow sufficient transport time when scheduling the time of biopsy.

Requests and Reports

A request form must accompany the specimen. The request form must contain full details (full name, address, contact number) of the requesting doctor and who should receive a copy of the report, including the name of the treating neurologist.

VNLS is a statewide referral service with a broad clinician referral base. Please provide clear and precise details so reports can be directed to the appropriate people.

Specimen Collection

Nerve biopsy kit

VNLS provides nerve biopsy kits for appropriate specimen collection and packaging. It is essential to use these kits for sample collection as they contain the appropriate fixative, specimen containers and a nerve hook (1g weight). Each kit contains detailed instructions on nerve collection procedures.

Kits are provided free of charge. Contact the laboratory 48 hours prior to the procedure to ensure a kit can be delivered in time. Kits are delivered via courier at no charge.

Correct handling of nerve biopsies is important for accurate interpretation of the specimen.

• ***Kits supplied with separate 25% glutaraldehyde & cacodylate buffer must be MIXED before use.
• Take 25mm of nerve & tie a suture on the distal end of the nerve.
• Attach nerve hook to the other end.
• Place the nerve with suture & hook into the glass tube provided (2.5% glut fixative).
• Clamp the suture in the stopper of the glass tube & make sure the hook is suspended. 
• Please keep the glass tube UPRIGHT & place the glass tube into the plastic cup provided.
• Place the cup into an esky surrounded by ice cubes & dispatch to VNLS.

Specimen Dispatch

Return the nerve biopsy and completed paperwork to:

Victorian Neuromuscular Laboratory Service

Alfred Pathology Central Specimen Processing
The Alfred
55 Commercial Rd
Melbourne
Victoria 3004

VNLS must receive samples before 4.00pm Monday to Friday so ensure you allow sufficient transport time when scheduling a biopsy.

Victorian Neuromuscular Laboratory Service– General Information

Frequency

Daily

Weekdays

Collection & Request Instructions

Nerve Biopsy

Nerve biopsy for neurodegenerative studies are processed by the Victorian Neuromuscular Laboratory Service (VNLS) which is located within the Anatomical Pathology Department of Alfred Pathology Service at Alfred Health.

Clinicians Please Note: VNLS must receive samples before 4.00pm Monday to Friday to enable optimal handling and processing to occur. Please ensure you allow sufficient transport time when scheduling the time of biopsy.

Requests and Reports

A request form must accompany the specimen. The request form must contain full details (full name, address, contact number) of the requesting doctor and who should receive a copy of the report, including the name of the treating neurologist.

VNLS is a statewide referral service with a broad clinician referral base. Please provide clear and precise details so reports can be directed to the appropriate people.

Specimen Collection

Nerve biopsy kit

VNLS provides nerve biopsy kits for appropriate specimen collection and packaging. It is essential to use these kits for sample collection as they contain the appropriate fixative, specimen containers and a nerve hook (1g weight). Each kit contains detailed instructions on nerve collection procedures.

Kits are provided free of charge. Contact the laboratory 48 hours prior to the procedure to ensure a kit can be delivered in time. Kits are delivered via courier at no charge.

Correct handling of nerve biopsies is important for interpretation of the specimen.

• Please take 25mm of nerve & tie a suture on the distal end of the nerve.
• Attach nerve hook to the other end.
• Place the nerve with suture & hook into the glass tube provided (2.5% glut fixative).
• Clamp the suture in the stopper of the glass tube & make sure the hook is suspended (refer to picture).
• Please keep the glass tube UPRIGHT & place the glass tube into the plastic cup provided.
• Place the cup into an esky surrounded by ice cubes & dispatch to VNLS.

Specimen Dispatch

Return the nerve biopsy and completed paperwork to:

Victorian Neuromuscular Laboratory Service

Alfred Pathology Central Specimen Processing
The Alfred
55 Commercial Rd
Melbourne
Victoria 3004

Important Note: VNLS is unable to provide a collection service for the return of specimens. It is the responsibility of each hospital or clinic to arrange return delivery of the specimen to Alfred Pathology.

VNLS must receive samples before 4.00pm Monday to Friday so ensure you allow sufficient transport time when scheduling a biopsy.

Victorian Neuromuscular Laboratory Service– General Information

Nerve Biopsy

Nerve biopsy for neurodegenerative studies are processed by the Victorian Neuromuscular Laboratory Service (VNLS) which is located within the Anatomical Pathology Department of Alfred Pathology Service at Alfred Health.

Clinicians Please Note: VNLS must receive samples before 4.00pm Monday to Friday to enable optimal handling and processing to occur. Please ensure you allow sufficient transport time when scheduling the time of biopsy.

Requests and Reports

A request form must accompany the specimen. The request form must contain full details (full name, address, contact number) of the requesting doctor and who should receive a copy of the report, including the name of the treating neurologist.

VNLS is a statewide referral service with a broad clinician referral base. Please provide clear and precise details so reports can be directed to the appropriate people.

Specimen Collection

Nerve biopsy kit

VNLS provides nerve biopsy kits for appropriate specimen collection and packaging. It is essential to use these kits for sample collection as they contain the appropriate fixative, specimen containers and a nerve hook (1g weight). Each kit contains detailed instructions on nerve collection procedures.

Kits are provided free of charge. Contact the laboratory 48 hours prior to the procedure to ensure a kit can be delivered in time. Kits are delivered via courier at no charge.

Correct handling of nerve biopsies is important for accurate interpretation of the specimen.

• ***Kits supplied with separate 25% glutaraldehyde & cacodylate buffer must be MIXED before use.
• Take 25mm of nerve & tie a suture on the distal end of the nerve.
• Attach nerve hook to the other end.
• Place the nerve with suture & hook into the glass tube provided (2.5% glut fixative).
• Clamp the suture in the stopper of the glass tube & make sure the hook is suspended (refer to picture).
• Please keep the glass tube UPRIGHT & place the glass tube into the plastic cup provided.
• Place the cup into an esky surrounded by ice cubes & dispatch to VNLS.

Specimen Dispatch

Return the nerve biopsy and completed paperwork to:

Victorian Neuromuscular Laboratory Service

Alfred Pathology Central Specimen Processing
The Alfred
55 Commercial Rd
Melbourne
Victoria 3004

VNLS must receive samples before 4.00pm Monday to Friday so ensure you allow sufficient transport time when scheduling a biopsy.

Victorian Neuromuscular Laboratory Service– General Information

Registration Instructions

This test requires approval by the Chemical Pathologist.

Collection & Request Instructions

1. Collect a full volume of blood into the required tube/s
2. Gently invert each tube 10x after the blood collection to ensure the preservative mixes with the blood.

Transport Instructions between sites and/or laboratories

Courier to be arranged by Alfred

Processing Instructions

Store blood at room temperature, do not refrigerate.

Preferred Specimen Type

Plasma

Blood

Optional Specimen Type

Serum

Optional Container Type

SST

Notes

Therapeutic levels.

Oxcarbazepine is rapidly metabolised to the active metabolite 10-OH carbamazepine, the preferred test for monitoring oxcarbazepine therapy.

Therapeutic levels: 10.0 - 35.0 mg/L

Oxcarbazepine is rapidly metabolised to the active metabolite 10-OH carbamazepine, the preferred test for monitoring oxcarbazepine therapy.

Therapeutic levels: 10.0 - 35.0 mg/L

Notes

Please note: from the 30/10/2024 Paracetamol is reported in mg/L. 

The protocol for treatment held in the Emergency Department should be studied and followed.

NOTE: Lower levels may be toxic in chronic users and patients with certain co-morbidities.

Alfred Health - Please refer to PROMPT guideline: MEDICATION GUIDELINE: ACETYLCYSTEINE (NAC) INFUSION 

Nomogram

Please note: from the 30/10/2024 Paracetamol is reported in mg/L. 

The protocol for treatment held in the Emergency Department should be studied and followed.

NOTE: Lower levels may be toxic in chronic users and patients with certain co-morbidities.

Alfred Health - Please refer to PROMPT guideline: MEDICATION GUIDELINE: ACETYLCYSTEINE (NAC) INFUSION

Notes

Please note: from the 30/10/2024 Paracetamol is reported in mg/L. 

The protocol for treatment held in the Emergency Department should be studied and followed.

NOTE: Lower levels may be toxic in chronic users and patients with certain co-morbidities.

Alfred Health - PROMPT guideline

MJA Paractemol Consensus Statement.

Please note: from the 30/10/2024 Paracetamol is reported in mg/L. 

The protocol for treatment held in the Emergency Department should be studied and followed.

NOTE: Lower levels may be toxic in chronic users and patients with certain co-morbidities.

Alfred Health - Please refer to PROMPT guideline: MEDICATION GUIDELINE: ACETYLCYSTEINE (NAC) INFUSION 

Nomogram

Notes

The protocol for treatment held in the Emergency Department should be studied and followed.

NOTE: Lower levels may be toxic in chronic users and patients with certain co-morbidities.

Nomogram

MJA Paractemol Consensus Statement.

Please note: from the 30/10/2024 Paracetamol is reported in mg/L. 

The protocol for treatment held in the Emergency Department should be studied and followed.

NOTE: Lower levels may be toxic in chronic users and patients with certain co-morbidities.

Alfred Health - PROMPT guideline

MJA Paractemol Consensus Statement.

Notes

The protocol for treatment held in the Emergency Department should be studied and followed.

NOTE: Lower levels may be toxic in chronic users and patients with certain co?morbidities.

Nomogram

MJA Paractemol Consensus Statement.

The protocol for treatment held in the Emergency Department should be studied and followed.

NOTE: Lower levels may be toxic in chronic users and patients with certain co-morbidities.

Nomogram

MJA Paractemol Consensus Statement.

Preferred Specimen Type

Serum
Plasma

Blood

Optional Container Type

SST

Collection & Request Instructions

Patients with potentially toxic concentrations are in danger of serious complications, especially liver damage, which may not become apparent for 2—4 days.

Specimen must be collected at least four (4) hours post-ingestion.

Patients with potentially toxic concentrations are in danger of serious complications, especially liver damage, which may not become apparent for 2—4 days.

Specimen must be collected at least four (4) hours post-ingestion.

Notes

The protocol for treatment held in the Emergency Department should be studied and followed.

NOTE: Lower levels may be toxic in chronic users and patients with certain co‑morbidities.

The protocol for treatment held in the Emergency Department should be studied and followed.

NOTE: Lower levels may be toxic in chronic users and patients with certain co?morbidities.

Nomogram

MJA Paractemol Consensus Statement.

Preferred Specimen Type

Serum

Blood

Notes

Therapeutic Range:  15 - 39 mg/L

Critical results notification:  50 mg/L

Please note: from 01/10/2024 units have changed from umol/L to mg/L.

To convert: mg/L x 4.31 = umol/L

Notes

Therapeutic Range:  40—80 umol/L

Therapeutic Range Source: Alinity c Phenytoin Reagent kit insert, July 2018

Test performed on Abbott Alinity

Measured (Total) Phenytoin consists of "(protein) bound" and "free" (pharmaceutically active) drug. Where plasma albumin is reduced, calculated free phenytoin may be requested to provide a better indication of possible drug toxicity. 

Therapeutic Range:  10.0 - 20.0 mg/L

Critical results notification:  30.0 mg/L

Please note: from 01/10/2024 units have changed from umol/L to mg/L.

To convert: mg/L x 3.97 = umol/L

Therapeutic Range Source: Alinity c Phenytoin Reagent kit insert, July 2018

Test performed on Abbott Alinity

Measured (Total) Phenytoin consists of "(protein) bound" and "free" (pharmaceutically active) drug. Where plasma albumin is reduced, calculated free phenytoin may be requested to provide a better indication of possible drug toxicity. 

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

Lithium Heparin (with Gel)

SST

Optional Container Type

SST

Collection & Request Instructions

** Pathologist approval required **

Transport Instructions between sites and/or laboratories

** Research use only **

Frequency

Weekdays

Notes

Method: LC-MS/MS

Target range: 8.0 - 64.0 mg/L

Optional Container Type

SST

Preferred Specimen Type

Serum

Blood

Alternative names

Prostate Specific Antigen; Free

Prostate Specific Antigen; Free, PSA Ratio

Notes

Therapeutic Range:  < 300 mg/L

Please note: from 01/10/2024 units have changed from mmol/L to mg/L.

To convert: mg/L x 7.24 = mmol/L

Therapeutic Range:  < 300 mg/L

Please note: from 01/10/2024 units have changed from mmol/L to mg/L.

To convert: mg/L x 0.00724 = mmol/L

Notes

Therapeutic Range:  1.0—2.5 mmol/L

Toxic range:  > 3.5 mmol/L

Therapeutic Range:  < 300 mg/L

Please note: from 01/10/2024 units have changed from mmol/L to mg/L.

To convert: mg/L x 7.24 = mmol/L

Optional Container Type

SST

Alternative names

Spinocerebellar Ataxia (Types 1. 2. 3. 6. 7. and 15) Test

Spinocerebellar ataxia repeat number multi-loci

Volume (Adults)

3 mL

Minimum/Paediatric Volume

5 mL

1 mL

External Laboratory

Victorian Clinical Genetics Services, RC Hospital

NSW Health Pathology, (SSWPS) - Concord Hospital

External Transport Instructions

Send at 4'C with Ice Pack

Send at ambient temperature

External Transport Instructions

This requst must be approved by the haematology registrar prior to sending

Notes

Please see link below for external laboratory requirements and costs

https://www.vcgs.org.au/order/tests/667

NSW Health Pathlogy Details

Preferred Specimen Type

Serum

Blood

Processing Instructions

Store at 4'C

Centrifuge
Aliquot
Store at -20'C

External Transport Instructions

Send Frozen on Dry Ice

Volume (Adults)

4 mL

Preferred Specimen Type

Blood
Bone Marrow

Blood
Bone Marrow
Tissue

Preferred Container Type

EDTA 3 mL

EDTA 10 mL
Slide

Collection & Request Instructions

Liase with Haematology Registrar on 63075 before collection.

Can be stored at 4'C for up to 3 days.

Liase with Haematology Registrar on 63075 before collection.

Can be stored at 4'C for up to 3 days.

Collect at room temperature. Store Blood and Bone Marrow in CSR fridge.

Frequency

Monthly

Optional Container Type

SST

Preferred Specimen Type

Serum

Blood

Optional Specimen Type

Plasma

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

Lithium Heparin (with Gel)

SST

Optional Container Type

SST

Alternative names

BUN

Notes

Therapeutic Range:  350—700 umol/L

There is a poor correlation between concentration and effect/toxicity.

Therapeutic Range Source: Alinity c Valproic Acid Reagent kit insert, October 2018

Test performed on Abbott Alinity

Therapeutic Range:  50 - 100 mg/L

There is a poor correlation between concentration and effect/toxicity.

Critical results notification:  120 mg/L

Please note: from 01/10/2024 units have changed from umol/L to mg/L.

To convert: mg/L x 6.93 = umol/L

Therapeutic Range Source: Alinity c Valproic Acid Reagent kit insert, October 2018

Test performed on Abbott Alinity

Preferred Container Type

SST

Lithium Heparin (with Gel)

Optional Container Type

Lithium Heparin (with Gel)

SST

Preferred Specimen Type

Serum

Blood

Preferred Specimen Type

Serum

Blood

Optional Specimen Type

Plasma

Notes

testing red bold text

Transport Instructions between sites and/or laboratories

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